CONNIE JENSEN (PT) – Physical Therapist, NPI 1366442915

CONNIE JENSEN (PT) is a healthcare provider. based in Fairfax, Virginia. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 2305001979 (VA). The NPI Number for CONNIE JENSEN (PT) is 1366442915

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
CONNIE JENSEN (PT)
NPI
1366442915
Phone
(703) 279-4394
Address
9900 MAIN ST
Enumeration Date
26 July 2005
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8885312204
Graduation Year
2006 (20 years ago)
PAC ID
0143741520
Group Practice PAC ID
2860649654
Professional Enrollment ID
I20250303001611
Address ID
VA234511683VI3317XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

3,079 PHYSICAL THERAPIST IN PRIVATE PRACTICE in VA

Provider Addresses for CONNIE JENSEN (PT)

  • 9900, Main Street, Green Acres, Fair Oaks, Fairfax, Fairfax (city), Virginia, 22030, United States

    SUITE 200A

    FAIRFAX, VA 220313907

    Phone: (703) 279-4394

    Fax: (703) 279-4214

    Type: Mailing

  • 8209 WATSON ST

    SUITE 100

    MC LEAN, VA 221024402

    Phone: (703) 734-2889

    Fax: (703) 734-2139

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-03-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250303001611IPhysical Therapist In Private PracticeVATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 22031)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2860649654View full group profile
NameSpecialtyState
-GA
Occupational Therapist In Private PracticeTN
Physical Therapist In Private PracticeVA
-FL
Occupational Therapist In Private PracticeVA
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeTN
Occupational Therapist In Private PracticeNV
Occupational Therapist In Private PracticeIL
Qualified Speech Language PathologistIL

Reviews

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Frequently asked questions

What identifier follows CONNIE JENSEN (PT) across health systems?
The NPI 1366442915 uniquely identifies CONNIE JENSEN (PT) in U.S. healthcare data.
Does the public listing show CONNIE JENSEN (PT) as active?
CONNIE JENSEN (PT)'s NPI record reflects an active status in NPPES.
How should patients interpret CONNIE JENSEN (PT)'s specialty?
The extract shows Physical Therapist for CONNIE JENSEN (PT). Clinical services aligned with this taxonomy classification.
What geographic area is tied to CONNIE JENSEN (PT)?
CONNIE JENSEN (PT) is associated with Fairfax, Virginia in the same public data insurers reference.
Why is information missing for CONNIE JENSEN (PT)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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